Research Stimulus Grants in Aging

Effects of Foot Structure and Foot Orthotics on Balance and Self-Perceived Stability in the Elderly

Project Description

Our own recent data indicate that foot structure may be related to postural control and balance,1 and extensive clinical experience indicates that foot orthotics and shoe wear improve balance for individuals who have either excessively supinated or pronated foot structure. In the case of the supinated (high arched foot) foot, we believe that postural control and balance are impaired because the individual has a relatively small base of support between the foot and the support surface. Postural control and balance for individuals with excessively pronated foot structure may be attributable to hypermobile/unstable function of joints within the foot. In addition to being cost effective, foot orthotic intervention does not require expensive and prolonged training time that is often associated with other balance intervention programs.

The overall goals of this area of investigation are to: 1) determine relationships among foot structure, pain, balance, and self perceptions of function; and 2) examine the effects of foot orthotic intervention on balance, falls risk, pain, and physical activity in the elderly.

The anticipated aims of the project for the Institute on Aging Research Stimulus Grant Program are:

1. to assemble an interdisciplinary team and begin planning a series of compelling projects for extramural funding;
2. to design and conduct a preliminary study to examine the relationship between foot structure and measures of balance and self reported perceptions of stability in a pilot study using a sample of older adults;
3. to design and conduct a preliminary study to examine the effects of foot orthotics on balance performance, pain, and self reported perceptions of stability in a pilot study using a sample of older adults;
4. to determine effect size and variability regarding the effects of foot orthotics on balance performance and self-perceptions of stability in a pilot study using a sample of older adults; and
5. to develop grant proposals for extramural funding to examine the associations of foot structure, balance, activity, and falls risk in older adults.

Funded by the Institute on Aging Research Stimulus Program

Team

Principal Investigator: Michael T. Gross, PT, PhD, Professor, Division of Physical Therapy

Investigator Team: Vicki S. Mercer, PT, PhD, Associate Professor, Division of Physical Therapy; Jan Busby-Whitehead, MD, Lead for Clinical Affairs at the Institute on Aging, Coordinator of Geriatric Services in the Division of General Medicine, Director, Program on Aging.

About the PI

Dr. Gross received a bachelor’s degree from Miami University, Oxford, Ohio in Psychology in 1976; a BS degree in physical therapy from the University of Florida in 1979; an MS in physical therapy/sports medicine from the University of North Carolina in 1983; and a PhD in Curriculum and Instruction from the University of North Carolina in 1986. He is currently a Professor in the Division of Physical Therapy and the Doctoral Program in Human Movement Science at the University of North Carolina at Chapel Hill, as well as an Adjunct Professor in the Department of Exercise Science at UNC. He teaches biomechanics and musculoskeletal assessment and intervention in these programs, and his research interests generally involve assessment and intervention strategies for lower quarter dysfunction, with a specific interest in foot orthotic intervention. He treats patients 1-2 days per week, most of whom have been referred for foot orthotic evaluation for lower quarter musculoskeletal dysfunction. Most recently, Dr. Gross has been named a Catherine Worthingham Fellow of the American Physical Therapy Association. The Fellowship recognizes his contribution to lasting and significant advances in the science, education and practice of the profession of physical therapy.